“I quit school in the sixth grade because of pneumonia. Not because I had it, but because I couldn’t spell it.” – Rocky Graziano Article Citation: Bauer TT, Ewig S, Marre R, Suttorp N, Welte T; CAPNETZ Study Group. CRB-65 predi…
Don’t forget to consider Fitz-Hugh-Curtis Syndrome in your right upper quadrant pain differential! Fits-Hugh-Curtis Syndrome is a rare disease process characterized by perihepatitis as a complication of pelvic inflammatory dise…
“Dogs never bite me. Just humans.” -Marilyn Monroe Human bites are the third most common bite after dog and cat bites. They occur more frequently in males, typically between the late teens and in the twenties. Clos…
Article Citation: Weiss EA, Oldham G, Lin M, Foster T, Quinn JV. Water is a safe and effective alternative to sterile normal saline for wound irrigation prior to suturing: a prospective, double-blind, randomised, controlled clinical trial….
Article Citation: Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004 Jul;…
A mother brings her 4 day old newborn baby boy into the Peds ED for bilateral eye discharge. Mom tells you he was full-term and healthy, but she did not have prenatal care. The baby is well appearing and is eating, urinating and defecating …
So you’ve I&D’d that abscess, there’s no surrounding cellulitis you’re ready to Treat em’ and Street em’ but the patient asks: “Can I have some antibiotics, please? And maybe a sandwich?”…
Todays pearl was inspired by the amazing and innovative Dr. Vella and Dr. McVane. We all have had the joy of draining a large pilonidal abscess. You know the second that abscess opens white pus will flow freely creating mountains of…
A 43 yo M presents with LLQ abd pain, non-bloody diarrhea and subjective fever for 1 d. His vitals are normal, has a WBC of 14 but otherwise normal labs. He is given IV analgesia and clinically has improved, tolerating PO. CT abdomen and…
25 y/o F with multiple painful lesions of the right gingiva and low grade fever. The symptoms started off as a stinging sensation with sensitivity to the gums on her right side that she noticed 3 days ago, but now there are lesions that hur…
CMS recently produced a new sepsis measure/bundle that has many EM and critical care docs up in arms. I’m not going to focus on their definition of sepsis (save your rage for later), but instead on the fact that their definition of resusci…
You are taking a water break during your resus shift when you hear “clinical upgrade, acute zone 1”. You rush back to see a 60-year-old patient holding a bucket of bright red blood and you find out that he has an extensive PMH including Hep…
You are managing an elderly patient with septic shock. The ICU team is requesting ScvO2 measurement to be used in consideration of inotropic support. You are not sure how to make decisions about inotropes based on ScvO2 and wonder: What…
62 y/o M PMH of hep C cirrhosis, HTN, and anemia presents with fever to 101.6 and diffuse abdominal pain. Your patient has jaundice and abdominal distension and tenderness with shifting fluid wave. You work him up with labs, including a tap…
A 15yo girl comes into your ED complaining of unilateral facial swelling that started this morning as a little bit of swelling under her R ear, and 8 hours later, is now her entire R cheek. No fevers/chills. ROS otherwise negative. VS norma…
